Changes are expected in the care of cancer patients in Latvia

The citizens of Latvia can expect improved cancer screening, more personalized medicine, improved access to targeted therapy, palliative care, and more opportunities for patients. In a special project funded by the European Union, after appropriate research, a series of solutions to problems in the care of cancer patients in Latvia have been found. On March 8-9, the international experts involved in the project presented their recommendations to those involved in the Latvian health sector. By implementing these recommendations, a decrease in the burden of cancer in Latvia is expected - better survival rates and a better quality of life.

Since the beginning of 2022, experts from the World Health Organization's International Agency for Research on Cancer (IARC/WHO), the Organization of European Cancer Institutes (OECI) and the Erasmus University Medical Center (EMC) have visited Latvia several times to exhibit action plans, strategic guides and practical guidance on how to improve the effectiveness of various elements of cancer care. The European Commission has defined the fight against cancer as its main priority in the field of health. Improvements in the field of cancer have also been set as a priority by the Ministry of Health of Latvia.

The project "Improving cancer care coordination and screening in Latvia and Slovakia" in Latvia was initiated and coordinated by the Institute of Clinical and Preventive Medicine of the University of Latvia (UL ICPM). Based on the recommendation of the international experts involved in the project, a Steering Committee of the project was established. It is led by the Minister of Health of Latvia Līga Meņģelsone and consists of representatives of several participating ministries - Ministries of Health, Education and Science, Finance, Environmental Protection and Regional Development and their subordinate institutions, as well as representatives of patients and other institutions. Such multifaceted institutional involvement is necessary as all these parties are involved in improving cancer care processes.

The expertise of the project is divided into three equally important areas, in which the improvements must be implemented in an interconnected manner. First of all, it is necessary to introduce an effective population-based cancer registry in Latvia. With the help of this register, such data is calculated and analyzed that characterizes the burden of cancer and helps in making decisions for disease control - to set priorities, resource allocation and evaluate the progress of cancer patient care. In the creation and maintenance of the register, international standards must be followed, which allow obtaining indicators that are comparable at the international level. An essential prerequisite for a well-functioning cancer registry is the full involvement of medical institutions and professionals who need to enter these data, ensuring full data entry. “Without a cancer registry, it is impossible to improve processes related to cancer care - we simply do not know what needs to be improved. Therefore, the creation of a good register is the first and most important step for the implementation of all future recommendations," explains the co-chairman of the project in Latvia, director of UL ICPM, prof. Mārcis Leja.

Secondly, it is necessary to improve the efficiency of cancer screening in Latvia. The involved international experts indicate that well-organized cancer screening is cost-effective. Also in this area, it is necessary to ensure systematic registration of screening quality parameters in accordance with international standards, moreover, in a database that would allow these data to be merged with those recorded in the cancer registry. "Thanks to the responsiveness of the Ministry of Health and its subordinate institutions - the Center for Disease Prevention and Control and the National Health Service - significant progress has already been made in the planning of such a data system. Our task now is to create such a registry and get it used by all participating organizations, then to achieve the minimum quality indicators that are a mandatory prerequisite for an organized cancer screening," comments prof. Mārcis Leja.

Thirdly, Latvia must take targeted steps towards the establishment of a Comprehensive Cancer Center and a Comprehensive Cancer Network, which would also be included in the relevant network of European Cancer Centers. Such a center would be an institution oriented towards comprehensive cooperation, where patients could receive not only the highest quality cancer treatment and care, but where the cancer research and education processes of all participating organizations - research institutes, universities, laboratories - would be concentrated. At the same time, the path of the Riga Eastern Clinical University Hospital to the establishment of an internationally accredited Cancer Center, which could eventually serve as the core of a Comprehensive Cancer Center, was started. The creation of a Comprehensive Cancer Network would mean that patients would receive equally high-quality cancer treatment not only at Riga Eastern Clinical University Hospital, but also in Liepāja, Daugavpils and other Latvian hospitals.

As one of the most significant challenges in the implementation of recommendations in Latvia, the experts involved indicate the currently low interoperability of organizations - related to the availability of health data at the clinical level. ”Latvia has skilled specialists. The implemented "green corridor" system, in which symptomatic patients receive access to treatment outside the waiting line, is a positive thing. To improve the efficiency of cancer care, it is very important to improve the data system and integrate all the elements of the developed recommendations. For project outcomes to be sustainable, the commitment of local stakeholders is important. We see that Latvia's policy makers and decision makers are ready to put our prepared recommendations into practice, and so we expect a positive impact moving forward,” comments the principal investigator of the project Andre Carvalho (IARC/WHO).

In the course of the project, as the experts regularly communicate with Latvian health sector specialists, the practical implementation of the recommendations has already begun. The European Commission will continue to follow the progress of the implementation of the recommendations in Latvia.